Cost Breakdown Research Articles

From electrophysiological exploration to management of heart arrhythmias: Economic analysis of practices in a high-volume French hospital over two different time periods

Medical devices (MD) used to treat arrhythmias range from electrophysiological exploration catheters to intracardiac ablation catheters, and they are continuously undergoing optimization. The inclusion of innovative MD in Diagnosis Related Groups (DRG) of the French healthcare economic system can lead to financial imbalance for health institutions. The objective of this study was to compare cost-revenue analyses for interventional heart rhythm management in a high-volume French hospital between two time periods. For 3 months in 2014 and 3 months in 2017, all of the patients admitted to the interventional rhythmic unit with arrhythmia were included retrospectively in this monocenter study. All arrhythmias were considered. The primary clinical endpoint was the difference between the expenses and incomes, calculated for each patient. The secondary endpoint was the breakdown of costs. 217 patients were included. In 2014 period, the analysis revealed a deficit of 409±1717 euros per patient and an overall deficit for the hospital of 44,635 euros. In 2017 period, the same evaluation indicated a deficit of 446±1316 euros per patient and an overall deficit for the hospital of 48,210 euros. The cost of MD accounts for a significant share of total expenses. The profitability for the cardiac rhythm activity at our facility was optimized between 2014 and 2017. The reliance on ambulatory care increased. However, the reduction in the expenses incurred did not increase the profitability for the facility. It was offset by a decrease in DRG tariffs. A flowchart-type structure based on these practices analyses for rhythmic disorder treatments was developed.

Feasible route for the recovery of strategic metals from mixed lithium-ion batteries cathode materials by precipitation and carbonation

• Two recycling routes with high Li and Co recovery are designed and compared. • Three scenarios were compared to achieve an economically feasible recycling path. • Detailed breakdown of costs and gains in each step were analyzed. • Nano-sized Li 2 CO 3 and Co was recovered with high purity. Recycling routes and orientations set the tone for the feasibility of lithium-ion batteries (LIBs) recycling. An economically feasible hydrometallurgical route for the recycling of strategic metals from LIBs cathode materials was in great need both in the sense of achieving the sustainable development of clean energy and emissions reductions. Three scenarios with routes emphasis on higher lithium and cobalt recovery and orientations incline towards high overall recovery and profit, respectively, were compared, i.e., scenarios A and B with the same orientation (high overall recovery) in different routes (higher lithium and cobalt recovery, respectively), scenario B and C with same routes (high cobalt recovery) in different orientations (high overall recovery and profit, respectively). With the assistance of thermodynamic simulations and profit calculations, three scenarios were tested for recycling 1 Kg of spent cathode materials. The highest leaching and Li 2 CO 3 precipitation ratio were achieved in scenario A, followed by scenario B with the highest cobalt recovery ratio, however, the optimum profit was achieved in scenario C with the lowest costs. A comparison among scenarios A, B, and C indicate that a profit-oriented strategic metals recovery process is more reasonable for LIBs recycling.

Economic implications of adding a novel algorithm to optimize cardiac resynchronization therapy: rationale and design of economic analysis for the AdaptResponse trial

Aims Although cardiac resynchronization therapy (CRT) has proven beneficial in several randomized trials, a subset of patients have limited clinical improvement. The AdaptivCRT algorithm provides automated selection between synchronized left ventricular or biventricular pacing with optimization of atrioventricular delays. The rationale and design of the economic analysis of the AdaptResponse clinical trial are described. Rationale The costs associated with HF hospitalization are substantial and are compounded by a high rate of readmission. HF hospitalization payments range from $1,001 for Greece to $12,235 for US private insurance. When examining the breakdown of HF-related costs, it is clear that approximately 55% of the hospitalization costs are directly attributable to length of stay. Notably, the mean costs of a CRT patient in need of a HF-related hospitalization are currently estimated to be an average of $10,679. Methods The economic analysis of the AdaptResponse trial has two main objectives. The hospital provider objective seeks to test the hypothesis that AdaptivCRT reduces the incidence of all-cause re-admissions after a heart failure admission within 30 days of the index event. A negative binomial regression model will be used to estimate and compare the number of readmissions after an index HF hospitalization. The payer economic objective will assess cost-effectiveness of CRT devices with the AdaptivCRT algorithm relative to traditional CRT programming. This analysis will be conducted from a U.S. payer perspective. A decision analytic model comprised of a 6-month decision tree and a Markov model for long term extrapolation will be used to evaluate lifetime costs and benefits. Conclusion AdaptivCRT may offer improvements over traditional device programming in patient outcomes. How the data from AdaptResponse will be used to demonstrate if these clinical benefits translate into substantial economic gains is herein described.

Life cycle cost analysis of contaminated site remediation using information technology tools

Contaminated oil and gas well sites, disposal of chemical substances, and polluted landfills all result in environmentally hazardous conditions that plague our society today. Contaminated site remediation and reclamation are critical for sustainable resource development and management of cumulative environmental effects. However, it is challenging to improve remediation efficiency and reduce costs of remediation due to complex site environmental conditions. The objective of this paper is to develop an integrated approach of remediation assessment and total cost analysis on a single platform using SQL, Microsoft Azure, and PowerBI. The decision support tool aggregates data of contaminants, materials, and remediation alternatives at remediation sites and stores the information in a SQL database. The tool then compares alternative treatment options and their associated costs through cost breakdown of materials, labour, equipment, and energy. The results show that the tool is capable of life cycle cost analysis for the ex situ remediation technology, including biological, thermal, and chemical treatments. The built-in cost analysis fosters real-time availability of different treatment options which is geared towards providing an effective and efficient way to conduct a cost analysis for decision-makers with scalable, reliable, and robust analytical capabilities in a single system.

Systematic Review Comparing Cost Analyses of Fasciectomy, Needle Aponeurotomy, and Collagenase Injection for Treatment of Dupuytren's Contracture: Une analyse de coûts systématique comparant la fasciectomie, l'aponévrotomie percutanée à l'aiguille et l'injection de collagénase pou traiter la maladie de Dupuytren.

Surgeons now have a variety of treatment options for Dupuytren's contracture including traditional partial fasciectomy (PF), percutaneous needle aponeurotomy (PNA), and collagenase Clostridium histolyticum (CCH) injection. An important factor in clinical decision making is the cost-effectiveness of the various modalities, as will be discussed in this article. A literature search was performed by 2 independent reviewers. A total of 14 articles and 3 abstracts met inclusion criteria. Papers were excluded for non-English language, insufficient breakdown of costs by treatment type, promotional materials, or works-in-progress. Cost data were extracted and subsequently converted to US dollars. Weighted means were used to objectively pool data that were sufficiently similar in methodology and population. Seven observational cohort studies were pooled and found to have a weighted mean cost in favour of PNA at US$3335 per patient as compared to CCH at US$3673.14 and PF at US$4734.14. Two expected-value decision analysis models were in agreement that PF is not cost-effective, but they differed on whether PNA or CCH was the most cost-effective strategy. Two cost minimization studies agreed that CCH was less costly than PF by US$486. One cost-benefit analysis found no significant cost benefit to CCH or PF, but found significant indirect benefit to CCH. Overall 10 of 17 studies found CCH to be superior with respect to direct cost, indirect cost, or both. Only 2 of the 17 studies found PF to be the most cost-effective method. Of the 7 studies that considered PNA, 4 found it to be lowest cost. The vast majority of studies found PF to be the most costly treatment modality; however, it is still the treatment of choice in certain clinical scenarios. It is difficult to compare CCH to PNA, as many studies did not consider PNA. More studies, especially considering indirect costs, are required to be able to accurately determine which method is most cost-effective.

Incorporating outsourcing, stochastic failure, and scrap into batch fabrication planning

In batch production planning, managers must consider the unforeseeable circumstances in the fabrication process and resources available to meet demand on time and determine the optimal replenishment policy. To address these concerns, this study examines a hybrid fabrication system incorporating outsourcing, stochastic machine failures, and random scraps. The objective is to decide the optimal uptime that minimizes the overall system expenses. Assumptions in this study include a partial outsourcing plan associated with a higher unit cost, random scrap, and stochastic breakdown under an abort/resume policy, wherein repair of a machine begins immediately after a breakdown, and the production of the interrupted batch resumes as soon as it is completed. A precise model is developed to explore this specific problem. Mathematical derivations, optimization methodology, and a recursive algorithm are used to derive the optimal replenishment policy. The applicability of the results is illustrated by a numerical example. To facilitate managerial decision making, it reveals the individual and/or combined impact of outsourcing, scrap, and machine failure on (i) the optimal policy; (ii) the system’s different cost contributors; (iii) total system expenses; (iv) machine utilization; and (v) other key parameters of the problem.

S1361 Healthcare Resource Use and Associated Costs in the Three Years Following the Initial Diagnosis of Diabetic or Idiopathic Gastroparesis: A Retrospective Claims Analysis

INTRODUCTION: Diabetic gastroparesis (DG) and idiopathic gastroparesis (IG) are the two most common forms of gastroparesis (GP). Because of the limited treatment options, many patients (pts) have inadequate symptom control which may lead to increased healthcare resource use (HRU). This study aimed to quantify the economic burden in HRU and associated costs of DG/IG in the United States over the 3 years (yrs) after first GP diagnosis (dx). METHODS: Adults newly diagnosed with DG or IG were identified in Optum’s de-identified Clinformatics® Data Mart Database (Q1-2007 to Q1-2019). Pts were continuously enrolled for ≥1 yr before and ≥1 yr after their first GP dx (index date). For controls without GP dx, index dates were randomly selected. Pts with DG/IG were matched 1:1 to controls using a mixed approach of exact matching (i.e., age, sex, complete yrs of follow-up post-index) and propensity score matching (i.e., income, education, index yr, Charlson Comorbidity Index [CCI] comorbidities, diabetic complications [DG only]). All-cause HRU and direct healthcare costs per person-year (PPY) were compared between DG/IG cases and matched controls in the 3 yrs post index date. RESULTS: DG and IG cohorts included 18,015 and 14,305 pts (mean age: 62 and 54 yrs; 34% and 24% males), respectively. DG/IG pts had a high comorbidity burden at baseline (DG: 34% chronic pulmonary disease, 29% renal disease; IG: 28% chronic pulmonary disease). Demographics and CCI comorbidities were balanced between GP pts and controls (Table 1). DG/IG pts had significantly higher annual HRU compared to matched controls in the first 3 yrs post-index, with the highest gap observed in Yr 1 (Figure 1). Healthcare costs were also significantly higher for DG/IG pts vs. controls across all 3 yrs post-index (mean total cost differences PPY: DG Yr 1 $34,885, Yr 2 $28,071, Yr 3 $25,606; IG Yr 1 $23,176, Yr 2 $16,627, Yr 3 $14,396; see Figure 2 for Yr 1 cost breakdown by service setting). Patterns of disease burden did not change in a sensitivity analysis with additional adjustment for conditions associated with GP (e.g., anemia, anxiety disorder). CONCLUSION: This study showed a substantial economic burden of both DG and IG among adults, highest in the first yr after dx and persistent over 3 yrs. In the first yr after dx, DG and IG pts had healthcare costs approximately two-fold higher than for the matched controls, emphasizing the need for more effective treatments that may reduce the burden of illness.Table 1Figure 1Figure 2

An Exploration of Decision-Making under Threat

The use of threats to force supplier compliance is a common practice in current business affairs. Unfortunately, little is known regarding the supplier’s decision process to comply to or resist suc...

Treatment and Healthcare Cost Among Patients with Hip or Knee Osteoarthritis: A Cross-sectional Study Using a Real-world Claims Database in Japan Between 2013 and 2019.

The guidelines for osteoarthritis (OA) treatment recommend different therapies including pharmacotherapy, and several analgesic options are available for pain management. In Japan, research on hip and knee OA treatment trends is scarce and OA-related healthcare costs are unknown. Therefore, this study aimed to examine the treatment and healthcare cost trends among Japanese patients with hip or knee OA. This was a cross-sectional study held between 2013 and 2019, using a medical claims database. The demographic and treatment characteristics of hip or knee OA patients for each year were descriptively analyzed and the medians for healthcare utilization and all-cause healthcare costs were calculated. The yearly mean age of 59,218 hip OA and 270,722 knee OA patients ranged from 66.3 to 68.6years and 71.1 to 73.1years, respectively. The prevalence of comorbidities was higher in knee OA than hip OA. In both groups, > 70% of patients were female, and the most common treatment was pain-related medication. In hip OA, topical and systemic nonsteroidal anti-inflammatory drugs (NSAIDs) were mostly used throughout the study period (34.1-41.4% and 32.0-40.3%, respectively). Similarly, in knee OA, topical and systemic NSAIDs were used in 58.3-63.3% and 36.5-46.0% patients, respectively. Increase in the use of acetaminophens (10.9% in hip OA and 10.2% in the knee OA) and weak opioids (3.7%, and 3.4%, respectively) from 2013 to 2019 were observed. Most patients were treated as outpatients in both groups. The median all-cause healthcare costs were approximately 35,000 JPY for hip OA and 74,000 JPY for knee OA. Although a considerable change in total healthcare cost was not observed in our study, the contents of medical treatment and cost breakdown were greatly altered due to the treatment and cost for OA itself, and the treatment and cost for comorbidities. Similar studies to investigate such a trend may help predict necessary resources and social needs. Thus, further investigation utilizing other databases is needed.

Budget Impact Analysis of Preoperative Radioactive Seed Localization.

This study models costs in implementing a radioactive seed localization (RSL) program for nonpalpable breast lesions at a large Canadian tertiary hospital to replace existing wire-guided localization (WGL). All direct and indirect operating costs of localization per lesion from the hospital's perspective were determinedby retrospectively reviewing patient data and costs from January 2014to December 2016. A budget impact analysis and sensitivity analysis were performed to calculate the mean cost per lesion, the minimum and maximum cost per lesion, operational costs, and initial costs. There were 265 WGL lesions in 2014 and 170 RSL lesions in 2016 included in cost calculation. The mean cost per localization was $185 CAD for WGL ($148-$311) and $283 CAD ($245-$517) for RSL using preloaded seeds, adjusted to 2016 Canadian dollars. The annual operational expenditure including all localizations and overhead costs was $49,835 for WGL and $80,803 for RSL. Initial costs for RSL were $22,000, including external training and new equipment purchases. Our budget impact analysis shows that RSL using preloaded radioactive seeds was more expensive than WGL when considering per-lesion localization costs and specific costs related to radiation safety. Manually loading radioactive seed could be a cost-saving alternative to purchasing preloaded seeds.Our breakdown of costs can provide a framework for other centres to determine which localization method best suit their departments.

An analytical cost estimation model for the design of axisymmetric components with open-die forging technology

Open-die forging is a manufacturing process commonly used for realising simple shaped components with high mechanical performances and limited capability in terms of production volume. To date, an analytical model for estimating the costs of components manufactured with this technology is still an open issue. The paper aims to define an analytical model for cost estimation of axisymmetric components manufactured by open-die forging technology. The model is grounded on the analysis of geometrical features available at the design stage providing a detailed cost breakdown in relation to all the process phases and the raw material. The model allows predicting product cost, linking geometrical features and cost items, to carry out design-to-cost actions oriented to the reduction of manufacturing cost. The model is mainly conceived for design engineers, cost engineers and buyers, respectively, for improving the product design, the manufacturing process and the supply chain. Cost model and related schemas for collecting equations and data are presented, including the approach for sizing the raw material and a set of rules for modelling the related cost. Finally, analytic equations for modelling the cost of the whole forging process (i.e. billet cutting, heating, pre-smoothing, smoothing, upsetting, max-shoulder cogging, necking and shoulders cogging) are reported. The cost model has been tested on eight cylindrical parts such as discs and shafts with different shapes, dimensions and materials. Two forge masters have been involved in the testing phase. The absolute average deviation between the actual and estimated costs is approximately 4% for raw material and 21% for the process. The absolute average deviation on the total cost (raw material and manufacturing process) is approximately 5%.

Low-Carbon Footprint Hydrogen Production from Natural Gas: A Techno-Economic Analysis of Carbon Capture and Storage from Steam-Methane Reforming

Enabling cost-efficient low-carbon footprint hydrogen production is key to achieve the ambition of the Paris Agreement. This study aims to understand the techno-economic performances of hydrogen production from natural gas without and with carbon capture and storage. A hydrogen plant, based on steam-methane reforming and located in Northern Norway, producing 450 t H2/d is here modelled and evaluated. Hydrogen production costs without and with carbon emissions capture and storage of 12.2 and 18.1 c€/Nm3 are obtained. This hydrogen cost increase results in a CO2 avoidance of 67 €/tCO2,avoided. The main contributor to the CO2 avoidance cost is the CO2 capture and conditioning (57 %), while pipeline transport and the storage contribute to 17 % and 26 %. Equally important, a semi-detailed cost breakdown is presented to provide a deeper understanding of the key contributors to the cost of the whole chain and to identify points which if reduced could have the most impact.

A two step approach for making super capacitors from waste wood

Waste management is essential for the sustainable development of society. Herein, a strategy was tested for dealing with large volumes of forestry wood waste. Activated carbon monoliths were prepared for application in super capacitor electrodes, using mulberry wood as a raw material. A two step pyrolysis method combined with chemical activation was developed for obtaining crack-free products. The hierarchically porous framework of wood was preserved in the first step of pyrolysis. In the following step, activation conditions were optimized by orthogonal experiments and different activating agents. Results show that carbon monoliths activated by potassium hydroxide exhibited an optimal specific capacitance of 95 F/g, due to their high specific surface area (424 m2/g) and rich micropore volume (0.13 cm3/g). Although the specific capacitance was not highly competitive, the total capacitance (4.7 F for 1 cm2 of one electrode) was much higher than that of common pellet electrodes (about 0.5 F). Finally, technical-economic assessment confirmed the potential for energy saving from an industrial perspective, and a cost breakdown of 4.6 $/kg was expected in electrode assembly process. This strategy has the potential to be used for many other waste woods worldwide and holds much promise for the advancement of sustainable energy industries.

Private and Externality Costs and Benefits of Recycling Crystalline Silicon (c-Si) Photovoltaic Panels

With solar photovoltaics (PV) playing an increasing role in our global energy market, it is now timely and critical to understand the end of life management of the solar panels. Recycling the panels can be an important pathway, possibly recovering a considerable amount of materials and adding economic benefits from currently installed solar panels. Yet, to date, the costs and benefits of recycling, especially when externality costs resulting from environmental pollution are considered, are largely unknown. In this study, we quantified the private and externality costs and benefits of recycling crystalline silicon (c-Si) PV panels. We found that the private cost of end-of-life (EoL) management of the c-Si PV module is USD 6.7/m2 and much of this cost is from transporting (USD 3.3/m2) and landfilling (USD 3.1/m2), while the actual recycling process (the cost of consumed materials, electricity or the investment for the recycling facilities) is very small (USD 0.3/m2). We found that the external cost of PV EoL management is very similar to the private cost (USD 5.2/m2). Unlike the breakdown of the private costs, much of the externality costs (USD 4.08/m2) come from the recycling process, which suggests that more environmentally friendly methods (e.g., recycling methods that involve fewer toxic chemicals, acids, etc.) should be preferred. We estimated that the total economic value of the recycled materials from c-Si PV waste is USD 13.6/m2. This means that when externality costs are not considered, the net benefit of recycling is USD 6.7; when the externality cost of recycling is considered, there is still a net benefit of USD 1.19 per m2.

Health Care Costs Associated to Type of Feeding in the First Year of Life.

Background: Breastfeeding is associated with lower risk of infectious diseases, leading to fewer hospital admissions and pediatrician consultations. It is cost saving for the health care system, however, it is not usually estimated from actual cohorts but via simulation studies. Methods: A cohort of 970 children was followed-up for twelve months. Data on mother characteristics, pregnancy, delivery and neonate characteristics were obtained from medical records. The type of neonate feeding at discharge, 2, 4, 6, 9 and 12 months of life was reported by the mothers. Infectious diseases diagnosed in the first year of life, hospital admissions, primary care and emergency room consultations and drug treatments were obtained from neonate medical records. Health care costs were attributed using public prices and All Patients Refined–Diagnosis Related Groups (APR–DRG) classification. Results: Health care costs in the first year of life were higher in children artificially fed than in those breastfed (1339.5€, 95% confidence interval (CI): 903.0–1775.0 for artificially fed vs. 443.5€, 95% CI: 193.7–694.0 for breastfed). The breakdown of costs also shows differences in primary care consultations (295.7€ for formula fed children vs. 197.9€ for breastfed children), emergency room consultations (260.1€ for artificially fed children vs. 196.2€ for breastfed children) and hospital admissions (791.6€ for artificially fed children vs. 86.9€ for breastfed children). Conclusions: Children artificially fed brought about more health care costs related to infectious diseases than those exclusively breastfed or mixed breastfed. Excess costs were caused in hospital admissions, primary care consultations, emergency room consultations and drug consumption.

P0718HEALTH CARE COSTS IN CHRONIC KIDNEY DISEASE: A LONGITUDINAL STUDY FROM THE PIRP COHORT

Abstract Background and Aims Health care costs in patients with chronic kidney disease (CKD) vary widely according to patients’ severity. In patients followed up in a community-based project, it is of interest to determine cost variations over time, as a result of treatment and CKD progression. The aim of the study was to estimate the costs incurred by the health care system for CKD patients in an Italian region. Method Patients recruited in the Emilia-Romagna (Italy) PIRP project in the years 2007-2014 with CKD stage 3a to 5 were included in the study. Patients were stratified at baseline into 7 groups at different risk of progression according to the CT-PIRP classification (Rucci et al., A clinical stratification tool for chronic kidney disease progression rate based on classification tree analysis, NDT 2014). To calculate the annual medical costs, we multiplied the number of services used by the respective unit cost. Per capita costs were obtained dividing overall costs by person-years. We used DRG tariffs as a proxy of costs for hospital admissions, the regional nomenclator for outpatient visits and lab tests, and cost unit for prescribed drugs. Mixed effects generalized linear models were used to estimate the annual direct costs of CT-PIRP groups, adjusted for calendar year of entry in PIRP and local health authority of residence. Results The study cohort includes 7737 CKD patients, aged 73.2±11.6 years, 64.5% males, mostly in CKD stage 4 (3136, 40.5%) and 3b (2799, 36.2%); 697 patients (9.0%) entered the study at stage 5. The CT-PIRP classification and frequency distribution is shown in Tab.1. After 4 years, 5017 (64.8%) were still alive, 1743 (22.5%) died, 546 (7.2%) were on ESKD and 422 (5.5%) were lost. The overall direct costs of patients while still enrolled in the PIRP project decreased from 36.89 million € in the first year to 32.22 in the fourth year, while the per capita annual median costs were stable around 2200 €. The cost breakdown showed a decrease of hospitalization and drugs costs and an increase in specialty visits costs (Fig.1). The model-estimated average annual costs were significantly higher for proteinuric, low GFR patients of CT-PIRP groups 2 and 3 (7239 € and 8825 € respectively), while non-diabetic, younger patients of group 5 determined a significantly lower burden (3350 €).

Financing a Green New Deal

The Great Depression galvanized the New Deal in the United States to recover the economy, relieve the poor and unemployed, and reform the financial backbone of the country. Today, the impending adverse effects of climate change have governments proposing analogous Green New Deals. Recently in Energy Research & Social Science, Galvin and Healy critically examine the economic viability and wide-spanning societal, monetary, and environmental implications of the US Green New Deal proposals.

Predicting BIM labor cost with random forest and simple linear regression

The benefits of adopting Building Information Modeling (BIM) in a construction project have been well recognized. However, it involves additional labor costs and the timeliness of task completion should be considered because a BIM application may not be required (and paid for) by the owner in the current stage of BIM development. At present, a project manager often faces much risk in making decisions about the cost because the BIM labor cost is supposed to be proportional to the gross (or total) floor area in practice, and the project managers can only adopt simple linear regression to estimate it. Although this method is straightforward, it tends to have a high risk of estimation error. Therefore, this research tried to develop a new methodology based on Cross Industry Standard Process for Data Mining (CRISP-DM) and proposed a hybrid approach by combining Random Forest (RF) and Simple Linear Regression (SLR) for improving the accuracy of prediction on a project's BIM labor cost in construction phase. Case studies are conducted to demonstrate and validate the prediction results using nineteen completed BIM projects from a leading construction company in Taiwan. A cost breakdown structure (CBS) was proposed to establish the training data set for machine learning. Moreover, this study proposes the use of effective floor area, instead of gross floor area, to be one of the features for training RF and SLR models. Clustering analysis is also adopted and confirmed to improve model performance. Through comparative studies, the hybrid approach of prediction methodology proposed in this study has been proved to be effective in reducing the risk of BIM labor cost prediction.

Assessing the cost accuracy of electrical works towards sustainable procurement of building services

The inaccuracy of cost forecast for building services has being ascribed to the practice of allocating deterministic lump sum figure from historical data, as opposed to making detailed measurements. Using a quantitative research approach based on the analysis of project data, this study provides statistical evidence to reinforce this view point various researchers have embraced over the years. The study investigates the current practice and the levels of accuracy attainable with the cost estimation practices for electrical installations currently deployed in Port Harcourt, Nigeria. Cost data from one hundred and sixty-one Bills of Quantities are collated and statistically analyzed. The outcome of the research shows that an average of 65.83% of bills prepared by quantity surveyors for electrical installations, sampled within a six-year period, were computed using provisional sums while a percentage relative to 34.17% were measured in detail. The findings further showed statistically significant association between the method of estimating and level of accuracy. With significant disparity in the levels of accuracy of provisional sums allowed for electrical installations in bill of quantities (24.35%) compared to estimates generated through detailed measurement (9.77%). The study outcomes reinforced the need for systematic cost breakdown and financial management of electrical works in the procurement of buildings.

The Combination of Project Construction Management and Lean Construction Techniques in the Architectural Project

Main goal of Project Construction Management and Project Management is to delivery a project within scope, times and costs planned, obtaining a high quality standard. Instead, Lean Construction is focused on minimizing waste, in favor to creating maximum value for the client. The question to which this empirical research wants to answer is following: the integration of Project Construction Management and Lean Construction techniques could affect positively the respect of times and costs planned? To answer to the question it ideated a method that integrates the techniques of two methodologies. Then it applied in the architectural project of simulation in order to show the potentiality of the method. The workflow divided into three stages. At first stage, they identified the individual assegnments through Work Breakdown Structure. At second stage, it defined the Organizational Breakdown Structure. At last stage they planned the construction times and costs through Priced Bill of Quantity, Cost Breakdown Structure, Gantt Chart and Last Planner® System. The hypothesis on expected results deriving from the application of the method and they could led to thinking an improvement of project performance in terms of times and costs planned, respect to only Project Construction Management techniques. Future researches could be experimental, involving enterprises ed implementing the methodology in real study cases, using also the Building Information Modelling.